Historia Clinica - Terapia Ocupacional

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LOGO DE LA

Código

IPS DEL GOLFO

Historia Clínica Terapia Ocupacional Pagina

DATOS GENERALES  Nombre Edad Motivo de ingreso Procedencia Destino

1 de 3

 Nº de historia:

Hab. Nº:

DATOS CLÍNICOS Diagnóstico Principal Otros diagnósticos Historia clínica Fecha:

ASPECTOS MOTORES Tolerancia

Deformidades

Edema

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 Rango articular

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Coordinación

Destreza manual

COMPONENTES SENSORIALES Vista

Oído

Sensibilidad You're Reading a Preview

Propiocepción

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VALORACIÓN COMPONENTES COGNITIVOS  Nivel de conciencia

Atención

Memoria

Orientación

Esquema corporal

Afasia

Apraxia

Agnosia

Funciones ejecutivas

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COMPONENTES PSICOSOCIALES

Intereses

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 Autocontrol / Ansiedad

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OBJETIVOS DE TRATAMIENTO

ACTIVIDADES

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